Walsh & Hoyt: Head Trauma and Headache

Headache may occur after injury to the head, neck, or brain. The headache may be related to a structural lesion (e.g., headache attributable to intracranial hematoma), in which case management is directed toward the underlying etiology. A variety of pain patterns that resemble primary headache syndromes may develop after head injury. Tension-type headache is the most common pattern, but migraine without aura and a cluster-like pattern have also been described. The role of litigation in the development of posttraumatic headache syndromes has been studied, but a conclusive relationship has not been established. A causal relationship between head and/or neck trauma is difficult to establish in patients with very mild head trauma. In such cases, there is often a complex interplay between organic and psychosocial factors.